The attached table summarizes our preliminary assessment of the proposal’s budgetary effects and its likely impact on insurance coverage. According to that assessment, enacting the proposal would result in a net increase in federal budget deficits of about $1.0 trillion over the 2010–2019 period. Once the proposal was fully implemented, about 39 million individuals would obtain coverage through the new insurance exchanges. At the same time, the number of people who had coverage through an employer would decline by about 15 million (or roughly 10 percent), and coverage from other sources would fall by about 8 million, so the net decrease in the number of people uninsured would be about 16 million.

Seemed like America crossed a great threshold sometime between the last half of 2008 and the first half of 2009, when billions gave way to trillions as the biggest figures one could talk about in the public policy sphere. So a $1 trillion estimate doesn’t have quite the impact that it might have once had.